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County health in free market


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A companion example to the assessment of health care need in an isolated group of rural NC counties

A companion example to the assessment of health care need in an isolated group of rural NC counties

Published in: Health & Medicine

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  • 1. Population Healthcare Access and Health Status
    A single County example in North Carolina
  • 2. Social Systems Include Human Resources, Governance Structures, Work Processes, Technology and Capital
    Healthcare is a local phenomenon
    Health literacy is a local characteristic
    Definition of health is largely cultural
    Should our communities act locally in response to Federal and State standards through self definition?
  • 3. Our Regional PartnershipOften regional partnerships may be created:If the politics do not interfere.
    Possible 8 county collaborative
  • 4. Few US Citizens are familiar with the moral categories established by Adam Smith. Including those of nature: Propriety, Prudenceand Benevolence and Motive: Self-love, Reason and Sentiment. It is in this treatise that Smith first introduces the metaphor: 'The Invisible Hand' referring to society's self-regulation through channeling ambition to meet society's needs.
    High Low
    Where should the resources go?
  • 5. 2009 Medicaid Eligibility Will now expand greatly under PSACA
  • 6. There is a great distance between families and they travel farther for care
  • 7. Travel farther and have fewer choices
    Our counties
  • 8. Fewer choices for primary AND specialty care
    Note Specialty Care Deficit
  • 9. Who are our RAC’s Where are our trauma centers
    Our RAC
    So do patients with severe trauma go
  • 10. Where are they treated?
    Cross County Collaborative
    Residents Hospital Referrals
  • 11. Unusually high hospital discharge rates for conditions
    that should be treated in ambulatory setting
  • 12. How confusing can this get?Do we have a solution?
  • 13. County Health Profile
    Not so good news
    Good News
    Ref NC CATCH 2006
  • 14. Adolescent Health
    Ref NC CATCH 2006
  • 15. Adolescent Health
  • 16. Adolescent Health
  • 17. Cancer Prevalence
  • 18. Cancer Prevalence
  • 19. Typical Rural Cancer In NC
    Low prevalence
    VERY Important
    Low incidence rate
    Cancer caught in late stage
    Due to lack of screening
    High mortality
  • 20. Cancer in Sampson County
  • 21. Cardiovascular Disease
  • 22. Diabetes Outcomes
    Excessive mortality
    Excessive hospital days
    End Stage Renal Disease
    Excessive kidney failure
  • 23. Chronic Respiratory Disease
    Smoking and Smoking
  • 24. STDs
    Risky behavior
  • 25. Murder, Rape and Property Crime Sampson County
    Crime Risk
  • 26. Access to Dental Care
    Bad teeth = Bad Hearts
  • 27. Disability
    Children at risk
  • 28. Substance Abuse
  • 29. 29
    A Solution is needed to Manage the Supply Chain—Accessing Care Services based on Patient NeedsPlease do not forget rural America
    Targeted Patients with highly complex conditions (Top 1%)
    Case Management
    Targeted Patients with unstable chronic conditions, barriers to behavioral change and or multiple co-morbidities
    Extended Care Team Focus
    Care Coordination: Patient/Family Coaching
    & Care Coordination
    Scope, Intensity & Cost of Services
    Targeted Patients with uncomplicated chronic conditions and preventative care needs
    Medical Home contract established with population of focus
    Supported Self Management:
    Proactive Outreach & Monitoring Services
    Practice Focus
    Acute Care Only
    Informed Self Service : Education and Self Service Instructions
    Usual Care: Diagnosis & Treatment Services
    Distribution of Services across the Population
    Proprietary & Confidential
  • 30. Untangled Health Thanks You
    Do not hesitate to contact us for references.